CT扫描在子宫颈癌诊断和治疗中的价值

目的：探讨CT扫描在子宫颈癌的诊断及肿瘤分期中的应用价值。方法：对96例有完整盆腔CT增强扫描并经病理诊断证实为宫颈癌的患者的临床资料进行回顾性分析,分析CT扫描结果中肿瘤的影像学特征及对肿瘤分期的价值,并将CT成像结果与病理结果进行对比分析。结果：①96例患者中鳞癌84例,腺癌10例,腺鳞癌2例,临床病理分期：Ⅰa期8例,Ⅰb1期23例,Ⅰb2期21例,Ⅱa期19例,Ⅱb期16例,Ⅲ-Ⅳ期9例。②CT扫描肿瘤分期：扫描不能检出Ⅰa期宫颈癌;Ⅰb1期检出率为38例,低估6例;Ⅱa期22例,高估3例;Ⅱb期20例,高估4例;Ⅲ-Ⅳ期14例,高估5例。③CT表现：不能检测Ⅰa期宫颈癌;对于≥Ⅰb期肿瘤通过CT扫描可以检出,其中发现等密度病灶52例（54.2%）,低密度不均匀病灶40例（43.8%）,伴有低密度结节38例（39.6%）,高密度不均匀结节4例（4.2%）,转移淋巴结可以表现为肿大的圆形或椭圆形软组织影,中心低密度可有坏死。结论：CT扫描对于肿瘤分期≥Ⅰb期的宫颈癌有诊断意义,可以作为治疗前肿瘤分期的重要检查方法,但对于Ⅰa期宫颈癌,则不能通过CT扫描检出。

Evaluation of CT Diagnosis of the Cervical Carcinoma

Objective： To evaluate the value of CT scan in cervical cancer diagnosis and tumor staging application.Method：96 patients had complete pelvic CT scan and confirmed by pathological diagnosis of cervical cancer patients were retrospectively analyzed,CT imaging results were compared with pathological findings.Result： ① In all 96 patients,squamous carcinoma 84 cases,adenocarcinoma 10 cases,adenosquamous carcinoma 2 cases,clinical staging： Ⅰa 8 cases,Ⅰb1 23 cases,Ⅰb2 21 cases,Ⅱa 19 cases,Ⅱb 16 cases,Ⅲ-Ⅳ 9 cases.② CT scan tumor stage： Ⅰa scan couldn＇t be detected;Ⅰ b1 was detected in 38 cases,underestimate the 6 cases;Ⅱa 22 cases,overestimate 3 cases;Ⅱ b 20 cases,overestimate 4 cases;Ⅲ-Ⅳ of 14 cases,overestimated in 5 cases.③ CT manifestations： Ⅰ a period not detect cervical cancer;for ≥ Ⅰ b tumors can be detected by CT scan,which found that such density lesions in 52 cases（54.2%）,low-density heterogeneous lesions in 40 patients（43.8%）,accompanied by low-density nodulesin 38 cases（39.6%）,high density inhomogeneous nodules in 4 cases（4.2%）,lymph node enlargement can be expressed as a circular or oval-shaped soft tissue,the central density may have necrosis.Conclusion： CT scan for tumor stage ≥ Ⅰb stage cervical cancer diagnosis,tumor staging before treatment can be used as an important method of examination,but Ⅰa period of cervical cancer,can＇t be detected by CT scan.